Tajikistan, as well as the Kyrgyz Republic, Uzbekistan and Turkmenistan, is member of the Swiss-led voting group at the Bretton Woods Institutions. Switzerland shares the political responsibility to support and assist this constituency country. In the Central Asia region, Tajikistan, as well at the Kyrgyz Republic is a priority country for Swiss cooperation. A SDC/seco Regional Mid-Term Programme has been developed for 2002-2006 for the Central Asia region, in which Health has been identified as a priority domain of intervention, where SDC aims at ensuring equal access to basic, good quality and adequate public health care for the whole population. SDC interventions in the Health sector focus on Tajikistan and the Kyrgyz Republic. In Tajikistan, Health is one the two priority domains of intervention - the other being Governance.

SDC's strategy consists in supporting Health Sector Reform, including restructuring and rehabilitation of medical facilities and promotion of a decentralised preventive health care system; in addressing specific communicable diseases of poverty; and in emphasising health education and capacity building.

Poverty is a central development issue in Tajikistan. Since its independence from the former Soviet Union in 1991, Tajikistan has been exposed to civil war, natural disasters and economic failure. However, with the actual relative peace and stability in the country, with the resumption of economic growth since 1997, and with reforms being made to restructure the economy, one can hope that progress can be achieved in poverty reduction during the coming years. Recently, Tajikistan elaborated a Poverty Reduction Strategy Paper, which has identified Health and Education as 2 of 4 key sectors to fight poverty. 4 of the 9 indicators formulated as poverty reduction targets up to 2010 are directly linked to Health: reduction of infant mortality rate, reduction of maternal mortality rate, increase in pourcentage of the adult population with access to reproductive services, and increase in the proportion of the State budget allocated to Health.

In the Health sector, Tajikistan faces similar challenges as other former Soviet countries exacerbated, however, by war and a collapsing economy. To achieve the Sector Reform, a comprehensive plan, the so-called "Somoni Plan" has been elaborated with the support of WHO. Although the elaboration of the document associated civil society and community representatives in a limited way, it does emphasise the importance of the development of PHC services of good quality, in order to increase access to health care for the poor. In addition, it suggests the strengthening of public health services, including the prevention and control of TB, HIV/AIDS and malaria, as well as reproductive health services.

Beside several contributions to the rehabilitation and equipement of key health facilities, SDC supports two major projects in the Health domain in Tajikistan: SDC supports the Agan Khan Foundation's social development programme, which contributed to launch and test reform processes at the Oblast level since 1994 (Gorno Badakhshan Autonomous Oblast) - and which is developing mechanisms of cooperation with the Central Government in the framework of the National Reform of the Health Sector. SDC is launching since 2003 a major project aiming at supporting in a comprehensive way the sector Reform and Family Medicine in two pilot rayons, in close collaboration with the World Bank. This project is designed to complement an ongoing WB supported Primary Health Care Reform Project with components such as promotion of healthy lifestyle, monitoring and evaluation skills, mainstreaming HIV/AIDS, quality management and TB control.